| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92002 |
|
7,678 |
6,823 |
$287K |
| 92015 |
Determination of refractive state |
12,356 |
10,866 |
$252K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
4,624 |
4,003 |
$213K |
| V2020 |
Frames, purchases |
3,499 |
2,863 |
$213K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
32 |
32 |
$121.23 |
| V2744 |
Tint, photochromatic, per lens |
481 |
481 |
$0.00 |
| V2781 |
Progressive lens, per lens |
330 |
329 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
84 |
84 |
$0.00 |
| V2025 |
Deluxe frame |
559 |
558 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
13 |
13 |
$0.00 |